CORPORATE BOOK ORDER FORM – Advanced Incorporating Service

CORPORATE BOOK ORDER FORM

Attorney’s Name:

Attorney's Address:

Attorney's Phone:

Please choose one: *ProfitLLCLTDNon Profit

Name of Company:TYPE NAME AS YOU WOULD LIKE IT TO APPEAR IN THE CORPORATE BOOK. SPECIFY SPACES, PUNCTUATION AND CAPITALIZATION.

Year Company formed:

State of formation:

*FILL THIS SECTION OUT IF THE CORPORATE BOOK IS FOR A PROFIT CORPORATION/COMPANY

Capital Stock information:

Shares at $Par Value per Share (if any)

For Profit Corp., please choose slip case & binder color(standard is black):BlackBurgandyGreen

Please choose stock certificate color(standard is green):BlueBrownGreenOrangeRed

*FILL THIS SECTION OUT IF THE CORPORATE BOOK IS FOR AN LLC AND YOU WANT MEMBERSHIP UNIT INFO REFLECTED ON THE MEMBERSHIP CERTIFICATES

Membership Unit information:Units (if any)

Non-Profit/LLC/LTD, Please choose slip case & binder color(standard is black):BlackBurgundyGreen

Non-Profit/LLC/LTD, Please choose certificate color(standard is green):GreenBlue

Special Clauses/Restrictions (if any):

Ship via:Regular ShippingOvernight Shipping

Ship to information, if different from Bill to

Name

Street Address

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Country

Phone

Please fill this section out if you agree to have Advanced Incorporating Service bill your Credit Card:

Visa/MastercardAmexDiscover

Account #:

Exp date:

CV:(last three digits on back on all cards except Amex, four digits above logo in front of card)

Billing information of card/card holder

Name on the card

Billing address of card

Contacts